UCLA gets $7 million to study substance use and HIV among minority men who have sex with men

The National Institute on Drug Abuse has awarded UCLA a $7 million grant to investigate the links between substance abuse and HIV among Latino and African-American men who have sex with men.

Researchers will examine how non-injected drugs and alcohol can directly interact with the virus and other infectious diseases, to damage these men's health. Enrollment in the study begins in January.

Called MASCULINE (MSM and Substances Cohort at UCLA Linking Infections Noting Effects), the study will be led by Pamina Gorbach, a professor of epidemiology at UCLA's Fielding School of Public Health and a professor of infectious diseases at the David Geffen School of Medicine at UCLA, and Steven Shoptaw, a professor of family medicine at the Geffen School and director of the UCLA Center for Behavioral and Addiction Medicine.

For the study, researchers will establish and maintain an extensive repository of tissue, blood and fluid samples. This repository will be headed by Dr. Peter Anton, a professor of digestive diseases at the Geffen School. Anton, Gorbach and Shoptaw are also members of the UCLA AIDS Institute.

"Alcohol, non-injection use of cocaine and methamphetamine are linked to HIV sexual risk behaviors and transmission of infectious disease," Gorbach said. "But little is known about how these substances can affect biology to produce health threats among those living with or at risk for HIV -- especially among minority men who have sex with men."

MASCULINE will be a companion study to the Multisite AIDS Cohort Study, the first and largest study specifically created to examine the natural history of AIDS. It will be conducted through the Fielding School's Behavioral Epidemiology Research Group.

A team of clinical researchers, epidemiologists and basic scientists will collaborate to examine the direct effects of drug use on HIV acquisition and treatment, with the primary aim of determining whether and how the use of stimulants and other substances impacts the transmission of HIV and other infections among minority males who have sex with men whose HIV is poorly controlled or who are at high risk of being infected with the virus.

The study will involve a cohort of young substance users -- particularly users of stimulants -- who have poor histories of adhering to antiretroviral treatment, allowing researchers to test the biological influences of substances on immune function.

Findings from this unique cohort will shed light on the effects of substance use on the behaviors and clinical outcomes of both HIV-positive and high-risk, HIV-negative minority men that can ultimately be used to improve access to HIV prevention, treatment and care.

The epidemic of HIV among minority men who have sex with men in Los Angeles County, as well as in the U.S. as a whole, may be driven by the effects of drug use on individuals' adherence to their treatment regimens and on biobehavioral prevention, and it may be enhanced by network effects, the researchers said.

"This cohort is central to prevention and treatment efforts and will provide well-characterized, extensive repository samples for leveraged use with other cohorts, networks and individual's studies," Shoptaw said. "This unique cohort will facilitate studies on interactions between substance use and HIV progression and transmission, which are of critical public health significance."

The L.A. Gay and Lesbian Center will be one of the community sites for recruitment of HIV-positive participants for the study; the UCLA Vine Street Clinic will recruit HIV-negative participants.

The MASCULINE study is supported by the National Institute on Drug Abuse of the National Institutes of Health (U01DA036267).

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The L.A. Gay and Lesbian Center's clinical research program, under the direction of Dr. Robert Bolan, is dedicated to the conduct of rigorous research to contribute to scientific knowledge on the prevention, intervention and treatment of HIV and sexually transmitted infections; generate evidence-based practices; and improve the health and well-being of LGBT communities both locally, nationally and internationally. LAGLC has a long history of providing culturally competent, affordable, high-quality health care, mental health care and legal, advocacy and social services, among many other programs, to the LGBT community in Southern California. Clients are treated with compassion and respect, which inspires the trust and confidence necessary to enroll diverse, vulnerable populations in research studies so vital to the health of the community. The research program has been involved in similar cohort
studies, including the Multisite AIDS Cohort Study, since 2001 and has collaborated successfully with MASCULINE investigators on previous studies.

The UCLA Vine Street Clinic is a clinical research facility in Hollywood with a longstanding commitment to research on HIV prevention and substance-abuse treatment. Shoptaw and Gorbach established it in 2006 to conduct a 2,200 participant study of drug-related HIV transmission risks among substance users and their sexual partners. It has since become a certified clinical research site for the UCLA AIDS Prevention and Treatment Clinical Trials Unit with a substantial record of generating important knowledge about HIV in Los Angeles. The UCLA Vine Street Clinic is a recognized clinic within the UCLA Health System and can be accessed easily using public transportation by members of many communities who are affected by HIV and substance use.

The Behavioral Epidemiology Research Group (BERG) at the UCLA Fielding School of Public Health focuses on the prevention and treatment of sexually transmitted infections, including HIV; microbicides; new prevention technologies; and substance use practices. BERG works in diverse communities, conducting research in partnership with community agencies, clinics, research organizations, universities and public health departments.

The Center for Behavioral and Addiction Medicine (CBAM) in the UCLA Department of Family Medicine works to advance the prevention and treatment of chronic illnesses, especially in communities with health care disparities. The center's work has a strong focus on treating addictions and preventing the spread of HIV.

The UCLA AIDS Institute and Center for AIDS Research is a multidisciplinary group of top-flight researchers united in the worldwide fight against HIV/AIDS, the first cases of which were reported in 1981 by UCLA physicians. Institute members include researchers in virology and immunology, genetics, cancer, neurology, ophthalmology, epidemiology, social science, public health, nursing and disease prevention. Their findings have led to advances in preventing and treating HIV, as well as other diseases, such as hepatitis B and C, influenza, tuberculosis and cancer. To find out about ways to support these efforts, please contact Laura Pescatore at lpescatore@support.ucla.edu.

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